This WordPress.com site is the bee's knees

Menu

Monthly Archives: September 2015

Heel spurs, or abnormal growths of the heel bone, can cause sharp pains in the heel, especially first thing in the morning and after long periods of rest. In many cases, a heel spur develops as a result of plantar fasciitis, which is the inflammation of the ligament that stretches along the bottom of the foot, from the base of the toes to the heel. In individuals who suffer from plantar fasciitis, the ligament pulls away from the heel as the foot bears weight. In an effort to stabilize the ligament, the body may produce calcium deposits, which can then develop into heel spurs.

Causes

Heel Spur typically occurs in people who have a history of foot pain, and is most often seen in middle-aged men and women. The bony growth itself is not what causes the pain associated with heel spur. The pain is typically caused by inflammation and irritation of the surrounding tissues. Approximately 50% of patients with a heel spur also experience Plantar Fasciitis.

Symptoms

Heel spur and plantar fasciitis pain usually begins in the bottom of the heel, and frequently radiates into the arch. At times, however, the pain may be felt only in the arch. The pain is most intense when first standing, after any period of rest. Most people with this problem experience their greatest pain in the morning, with the first few steps after sleeping. After several minutes of walking, the pain usually becomes less intense and may disappear completely, only to return later with prolonged walking or standing. If a nerve is irritated due to the swollen plantar fascia, this pain may radiate into the ankle. In the early stages of Heel Spurs and Plantar Fasciitis, the pain will usually subside quickly with getting off of the foot and resting. As the disease progresses, it may take longer periods of time for the pain to subside.

Diagnosis

Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).

Non Surgical Treatment

Treatment of heel spurs is the same as treatment of plantar fasciitis. Because these problems are related, the treatment is the same. The first step in the treatment of a heel spur is short-term rest and inflammation control. Here are the steps patients should take in order to cure the symptoms of plantar fasciitis and heel spurs. Avoiding the activity that caused the symptoms is the first step in treatment. For example, take a few day off jogging or prolonged standing/walking. Just resting usually helps to eliminate the most severe pain, and will allow the inflammation to begin to cool down. Icing will help to diminish some of the symptoms and control the heel pain. Icing is especially helpful after a sudden flare up of symptoms. Exercises and stretches are designed to relax the tissues that surround the heel bone. Some simple exercises, performed in the morning and evening, often help patients feel better quickly. Many patients will work with a physical therapist, or you can try some simple activities on your own. If you need some help, meet with a therapist for a few sessions to learn a program you can continue on your own.

Surgical Treatment

Usually, heel spurs are curable with conservative treatment. If not, heel spurs are curable with surgery, although there is the possibility of them growing back. About 10% of those who continue to see a physician for plantar fascitis have it for more than a year. If there is limited success after approximately one year of conservative treatment, patients are often advised to have surgery.

Prevention

In 2002, researchers attempted to compare the effects of various running techniques on pronation and resulting injuries like stress fractures and heel spurs. They suggested that it is possible to teach runners to stride in such a way as to minimize impact forces. One way is to lower running speed. Another is to take longer rest periods following a run.

Heel spurs are a bone growth that extends from the heel bone, particularly on the bottom front of the heel bone and sometimes slightly to the side. Usually, a heel spur forms where the plantar fascia ligament attaches to the bottom of the heel bone. Those who overuse, or put heavy stress on the plantar fascia, are at risk of developing heel spurs.

Causes

Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.

Symptoms

It is important to be aware that heel spurs may or may not cause symptoms. Symptoms are usually related to the plantar fasciitis. You may experience significant pain and it may be worse in the morning when you first wake up or during certain physical activities such as, walking, jogging, or running.

Diagnosis

A thorough history and physical exam is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.

Non Surgical Treatment

Some heel spurs do require surgery, however surgery is a last resort. In most cases the patients underlying foot problem needs to be addressed, such as Over Pronation and Over Supination and Heel Pain Treatment Options need to be implemented if Plantar Fasciitis and Achilles Tendonitis are still an ongoing concern. Your best treatment is always prevention.

Surgical Treatment

Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery with typically smaller incisions on each side of your foot.

Prevention

Walk around before you buy shoes. Before you purchase your shoes, do the following. Re-lace the shoes if you’re trying on athletic shoes. Start at the farthest eyelets and apply even pressure to the laces as you come closer to the tongue of the shoe. Make sure that you can wiggle your toes freely inside of the shoe. Also, make sure that you have at enough space between your tallest toe and the end of the shoe. You should have room equal to about the width of your thumb in the tip of your shoe. Walk around to make sure that the shoe has a firm grip on your heel without sliding up and down. Walk or run a few steps to make sure your shoes are comfortable. Shoes that fit properly require no break-in period.